ABSTRACT: Suboptimal LH surges can lead to delayed or absent ovulation during reproductive management programs in cattle. Several signaling pathways may enhance the LH signal, potentially including growth factors. In the present study, we determined whether Fibroblast growth factor 18 (FGF18), which mimics some actions of the LH surge on granulosa cells, may potentiate the action of a suboptimal dose of LH using an established bovine granulosa cell (GC) culture system. Addition of recombinant FGF18 increased the concentration of progesterone (P4) in the culture medium. A combination of LH and FGF18 in the culture medium increased the abundance of mRNA encoding EREG, EGR1 and EGR3, proteins that are early modulators of the LH-induced pre-ovulatory cascade. This study demonstrated that FGF18 may be a co-factor in the regulation of the pre-ovulatory cascade in bovine ovarian granulosa cells.

RESUMO: Os picos de LH abaixo do ideal podem bloquear ou retardar a ovulação durante programas de manejo reprodutivo em bovinos. Várias vias de sinalização podem aumentar o sinal de LH, incluindo em especial fatores de crescimento. No presente estudo, determinamos se o fator de crescimento de fibroblastos 18 (FGF18), que estimula algumas ações do pico de LH nas células da granulosa, pode potencializar a ação de uma dose sub fisiológica de LH em um sistema de cultivo de células da granulosa bovina (GC). A adição de FGF18 recombinante aumentou a concentração de progesterona (P4) no meio de cultura. A combinação de LH e FGF18 no meio de cultura aumentou a abundância de mRNA para EREG, EGR1 e EGR3, proteínas que são moduladoras precoces da cascata pré-ovulatória induzida por LH. Este estudo demonstrou que o FGF18 pode ser um cofator na regulação da cascata pré-ovulatória em células da granulosa bovina.

BACKGROUND: The management of Gustilo-Anderson grade 3B open tibia fractures are challenging due to the high complication rates, including infection, non-union and amputation. Despite developing treatment options for these injuries, the optimal soft tissue cover option and timing of definitive surgery remains unclear and is often dictated by local context and available surgical expertise rather than the gold standard of care. The authors aimed to review the surgical techniques and outcomes for the management and reconstruction of the soft tissues in Gustilo-Anderson grade 3B tibia fractures treated at a tertiary hospital in South Africa. METHODS: A retrospective study was conducted on 22 patients who underwent soft tissue reconstruction for grade 3B tibia fractures from January 2014 to July 2017. Patient demographics, medical comorbidities, injury characteristics and management practices such as time to debridement, relook time, use of negative pressure wound therapy (NPWT), soft tissue coverage techniques and complications were recorded and analysed. RESULTS: Most patients were males (n = 18; 82%) with an average age of 39.3 years (range 15-69). Pedestrian vehicle accidents accounted for 45% (n = 10), followed by motor vehicle accidents (n = 6; 27%) and gunshot wounds (n = 2; 9%). Most patients (n = 18; 82%) were initially debrided within 24 hours. The mean time for NPWT usage prior to cover was 12.5 days. The mean time before soft tissue cover was attempted was 13.7 days (range 2-35). Fasciocutaneous flaps (n = 11; 50%) were the most common method used to achieve bony cover, followed by pedicled muscle flaps (n = 8; 36%), free flaps (n = 2; 9%) and skin grafts (n = 1; 5%). Most patients (n = 13; 59%) achieved satisfactory outcomes. Seven (32%) required soft tissue revisions. Additional complications included complete flap loss resulting in amputation, partial skin graft loss and soft tissue infection. Fewer complications were seen in patients who were first debrided within 24 hours from time of injury. CONCLUSION: Due to a resource constraint in our working environment, it is not possible to accurately follow available treatment guidelines in our management of grade 3B open tibia fractures. Despite this, the outcomes seen in this small sample were in keeping with those seen in the literature. Level of evidence: Level 4

A 16-year-old male presented with a 2-year history of a 5 x 5 cm dermatofibrosarcoma protuberans (DFSP) on the medial aspect of his right lower leg. Wide local excision (WLE) with a 2cm margin was performed and a free anterolateral thigh (ALT) flap was used to reconstruct the defect. This technique satisfactorily reconstructed a large defect in an adolescent with minimal donor site morbidity, as the donor site was closed primarily, and a functionally and aesthetically acceptable outcome. There was no evidence of tumour recurrence at 6 months follow-up.

Matrix metalloproteinases (MMP) are key enzymes involved in tissue remodeling. Within the ovary, they are believed to play a major role in ovulation, and have been linked to follicle atresia. To gain insight into the regulation of MMPs, we measured the effect of hormones and growth factors on MMP2 and MMP9 mRNA levels in non-luteinizing granulosa cells in serum-free culture. FSH and IGF1 both stimulated estradiol secretion and inhibited MMP2 and MMP9 mRNA abundance. In contrast, EGF and FGF2 both inhibited estradiol secretion but had no effect on MMP expression. At physiological doses, none of these hormones altered the proportion of dead cells. Although we cannot link MMP expression with apoptosis, the specific down regulation by the gonadotropic hormones FSH and IGF1 in vitro suggests that excess MMP2 and MMP9 expression is neither required nor desired for follicle development.